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To me it looks like Cherry angioma (especially on the first photo) but I am not sure, neither do I know whether cherry angioma can appear after acne. Cherry angiomas are spots that are very densely packed with capillaries and their appearance is shiny. Search the Internet for photos and info about it and let me know what you think. If it is not a cherry angioma, but just a strongly pigmented red spot, you could use microneedling on it.

For Cherry angiomas, you could try vascular laser or an old fashioned but still very effective electrocautery, cryotherapy, shave excision etc.

"Officially" only the rolling type of acne scars are tethered to the underlying structures but I also recommend suctioning for stubborn boxcar scars that has not improved after about one year of microneedling. It is worth trying.

I do not think applying sugary products to the freshly rolled skin is a good idea. Honey has trace amounts of minerals and vitamins (but sometimes also of pesticides) and other substances but its main content is glucose and fructose. That may be soothing to the intact skin but I would not apply it after rolling. Honey is poison, basically, in a way. The reason sugar has been used for thousands of years to preserve foods (jams, honey etc.) is that it kills bacteria and fungi. Sugars are very, very harmful to our organism, that is why people's legs need to be amputated etc. when they get diabetes that gets out of control. Sugar is so harmful to cells and organs (tissue damage through glycation) that we would die in hours after ingesting it, if it weren't for our insulin glands. I would not rub concentrated sugars into open skin, for lack of knowledge what would happen (but likely, bad things would happen..)

You can already order a dermastamp and the suction pump now because our shipping fees are based on weight so it will not cost you significantly more if you order the needles later.

Wash your stretch marks with water and soap and disinfect it with alcohol prior to microneedling. Post-microneedling, have a shower without using soap or anything else. Let it dry and apply the creams.

Yes, you do use the A-Ret cream (= Tretinoin cream). A-Ret is just a name of a cream containing the substance called Tretinoin (also called Retinoic Acid), which is acidic form of vitamin A. Use as explained in the link I gave you.

Tretinoin is useful for stretch marks but it does not protect or moisturize the skin after dermarolling/stamping. For that, we provide an ointment called Infadolan. You should apply Tretinoin to your stretch marks and on top of that, apply a little Infadolan.

I am not sure I understand your question. You had an IPL treatment two days ago and you already know it has left you with hypopigmented patches? That would be way too premature to judge.. You have to let the skin completely heal from the treatment first. Two months at least.

You have to keep the rolled/stamped area moisturized. An unused dermaroller will basically last forever.

Concerning hypopigmentation, I will paste here the text from our dermarolling instructions:

Hypopigmentation

Skin pigment (Melanin) is produced by melanocyte cells. They are at the bottom of the epidermis, whose thickness is 0.1 - 0.3 mm. When they produce too much Melanin in a certain area, you get hyperpigmentation. And when they do not produce enough or are destroyed or damaged, you get hypopigmentation.

Scar tissue differs from normal skin and one of the differences is that it has no, or badly functioning pigmentation processes.

Dermarolling often triggers the activity of melanocytes (pigment producing cells) or "wakes up" existing dormant melanocytes. In some cases the color turns completely back to normal (especially if there is hypopigmentation but no scar tissue, such as in Vitiligo for example) and in some cases the color improves but the scars remain still lighter than the surrounding skin.

If you have hypopigmented patches, stamp them every 10-14 days with a 1 mm dermastamp.

If you have a hypopigmented, hardened scar or if it is on an area with thick skin (such as the knees), use a 1.5 mm dermastamp. Stamp the hypopigmented patches and also stamp slightly outside of its borders to enable the migration of melanocytes from the surrounding normal skin into the hypo-pigmented areas.

Large hypopigmented areas: Roll up to three times a week with a regular 0.5 mm dermaroller. Roll over the hypopigmentation and roll further to normally pigmented skin to hopefully "harvest" some melanocytes and then roll back over the hypopigmentation. Ideally, combine rolling with stamping of the most hypopigmented patches.

When the skin is healed from microneedling, expose your hypopigmentation to the sun because Melanin is produced as a reaction to UV (provided there are melanocyte cells in the area to produce it).

Because it is rare for people to go public with their improvements (and even rarer to make high-quality before-and-after pictures as well) and also because this kind of feedback is so valuable to us, as a thank-you for the time and effort and an incentive to others, we are offering cesamaddict products from our store.

Honestly, I do not think you need or can do more than you already do. Your microneedling routine is good and you have to be patient and continue. Your skin is not irritated after daily application of high percentage Tretinoin which is quite rare.

If your red spots are infected/painful, you could try an OTC antibiotic cream or occasionally apply Betadine (a strong disinfectant). Buy either Betadine liquid or Betadine cream, not Betadine ointment because an ointment could trigger breakouts. Acne is not caused by bacteria but sometimes bacterial infections coexist in acne affected skin.

Concerning your scars, if they do not improve in about eight months, add a 1.5 mm dermastamp (the one with 35 needles) to your 1.5 mm dermarolling sessions. Stamp the scars and then roll the whole area.

>Can individuals with problem skin (acne, scarring, large pores etc) use the retin-a indefinitely? All>year round? Or would retin-a need to be cycled: 2months on, 1 month off (similar to what you>advised about hydroquinone)?

Retin A does not need to be cycled but it makes the skin more sensitive to UV so you either have to use a sunscreen or reduce or discontinue the application of Retin A in summer.

>Can I use the retin-a along the thin skin around the eye area: eyelid, undereye area? (I understand>this product is acidic and will sting)

In principle you can, but I do not really recommend using Tretinoin on the sensitive skin around the eyes. Our Infadolan ointment that contains Retinyl acetate is more suitable in this area. Apply daily, just a little.

Initially, Tretinoin makes the skin dry. Wrinkles and lines are more visible on dry skin and that is why it may seem in some cases that Tretinoin worsened wrinkles - but it did not. This is most likely to be the impression around the eyes where the skin is naturally less oily than elsewhere due to very few glands in the area.

>Once I've applied retin-a, is it fine to use an oil (olive oil, coconut, almond oil) over my skin as a>moisturiser? Or shall I wait until the morning to moisturise my face?

Vit. A is oil-soluble and you can use any kind of moisturizer on top of Retin A. Tretinoin (Retin A) dries out the skin (especially initially) and it is a very good idea to use a moisturizer and even heavy moisturizers such as oils to offset the drying effect.

If your scars are outside of the red area on the picture (from the above forum posting) or the skin with your scars can be stretched away from the red area, you can use a 1 mm dermastamp to improve their appearance.

It is not completely uncommon to get pinpoint bleeding with a 0.5 mm roller. We have customers who bleed, rolling their face with a 0.5 mm and we also have those who do not bleed at all rolling their face with a 2 mm roller. It depends on skin thickness but also on the density of the vascular network and their proximity to the skin.

Our customers haven't reported any problems with Tretinoin cream used on stretch marks on darker skin tones but just to be sure about each individual case, try it several times on one stretch mark only to see how your skin reacts - color-wise. When in doubt, apply it mainly to the stretch marks, trying to avoid the surrounding skin. You can apply it for example with a small piece of cotton pad wrapped around a tooth pick.

For pigmentation spots on large areas, buy a regular 0.5 mm dermaroller (roll the whole area three times a week) and a 1.5 mm dermastamp with 35 needles (stamp the individual dark spots every three weeks). Apply our 0.5 % Tretinoin cream into the spots right after stamping and also about three times a week (without stamping). A 0.5 mm roller will increase the turnover of the skin, which should improve pigmentations and the dermastamp will take care of deeper layers.

Do the same routine to the stretch marks on your calves. I usually recommend a combination of a regular 1.5 mm dermaroller and a 1.5 mm dermastamp and the Tretinoin cream for stretchmarks but in your case, it is not necessary to buy a 1.5 mm size roller if you use the above suggested tools for pigmentation.

You are in a hard spot because your hyperpigmented spots should be protected from the sun to avoid reappearance/worsening of the pigmentation whereas your stretch marks should be eventually sun exposed (if they are lighter than the surrounding skin) to encourage melanin pigment production.

You should keep the vit. C serum in a small airtight container and preferably in the fridge. Never store it in direct sun. Make smaller batches more frequently if you want to be sure. Check the color of your serum - it should be transparent, not yellow or orange.